PROJECT SUMMARY African American women suffer higher rates of hypertension, stroke, type II diabetes, stress, and depressive symptoms than do non-Hispanic white women. Prime Time Sister Circles (PTSC) empowers women to proactively manage their health by promoting the effective use of preventive health care; providing screening and monitoring of blood pressure and weight, and teaching strategies for managing stress, increasing physical activity, and improving nutrition. The 12-week community-based, holistic lifestyle intervention aims to improve care, reduce morbidity and mortality, and reduce health care costs through prevention, earlier detection, and improved management of chronic disease through a culturally tailored program addressing specific barriers experienced by midlife African American women. Improving the health habits and health knowledge of midlife African American women play a critical role in their own health and also impact the lives of their partners, children, grandchildren, and communities. Women in this age group are considered role models and influence the health knowledge, attitudes, and behavior of their families and communities. The proposed 5-year mixed methods study is a collaboration between The Johns Hopkins Center for Health Disparities Solutions (HCHDS), Gaston and Porter Health Improvement Center and the American Institutes for Research (AIR). We propose to survey African American women 40 to 75 years of age who participated in the PTSC between 2008 and 2014. We will collect data on blood pressure, health status, health behaviors, social support, social networks, and health care utilization through participant in-person surveys. We will compare African American women who participated in the PTSC (i.e., PTSC alumnae) to matched samples of African American women drawn from the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey (NHIS), and the Medical Expenditures Panel Survey (MEPS. Further, we will conduct focus groups and in-depth, semi-structured interviews with participants to explore their experience in PTSC, examine how perceptions of increased social support, and social networks created through participation in PTSC, influenced adherence to antihypertensive therapies and behaviors. We will use these data to address the following four specific aims: ? To determine if social support and social connectedness through PTSC sustained adherence to antihypertensive regimens among women who participated in PTSC. ? To determine if PTSC alumnae maintained improvements in their blood pressure and healthy behaviors (i.e, nutrition, physical activity, stress management, and the use of preventive healthcare services). ? To determine if PTSC alumnae have better blood pressure, BMI, and waist circumference and health behaviors compared to similar women who participated in the NHANES. ? To determine if PTSC alumnae have better health behaviors and health care utilization compared to similar women who participated in the NHIS and MEPS.